Healthcare Provider Details

I. General information

NPI: 1932416310
Provider Name (Legal Business Name): BARBARA L PURCELLA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 SENATOR DENNIS CHAVEZ BLVD SW ATRISCO HERITAGE HS
ALBUQUERQUE NM
87121
US

IV. Provider business mailing address

10800 SENATOR DENNIS CHAVEZ BLVD SW ATRISCO HERITAGE HS
ALBUQUERQUE NM
87121
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-1458
  • Fax:
Mailing address:
  • Phone: 505-243-1458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberNOT KNOWN
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: